Surang Chanyam

Among the many, many awards that line the windowsill of the Service Workers in Group Foundation’s conference room, there is a particularly impressive crystal affair sitting at the center of the display. It’s the Civil Society Partnership Award from the U.S. President’s Emergency Plan for AIDS Relief. PEPFAR is program responsible for channeling billions of dollars in U.S. funding to the global AIDS response over the past 22 years.

SWING’s Executive Director Surang Chanyam received the award at the 2016 International AIDS Conference. It seemed symbolic of a partnership that began in 2004 and has pioneered a model of community-run HIV services for sex workers and queer people across Thailand.

We can say that we were born from the support of PEPFAR. This is the first funding for SWING since the beginning.

Chanyam points the award out to me with no little irony. Just a few hours before she had attended a meeting in which she was told to no longer mention PEPFAR or use the program’s logo in any of her organization’s material.

SWING has actually not heard anything from PEPFAR – or any of their partners in the United States – since President Trump announced a pause on U.S. support to global HIV services in late January. Any communication has been channeled through their local funder, including that initial order.

They tell you, They are sorry for us, we have to stop anything. We have to stop the service. We have to stop work. We can’t do anything.

We couldn’t stop. This was 10:30 in the morning. That’s time for the clinic. In that time, the patients are in the clinic. And then we have to provide the service. But there is pressure for the counselor or for the staff who work in the clinic, because we think we cannot provide a service.

One of the cases, he does the testing and then his result is positive. The day before, on the 23rd, we can give them the medicine immediately. But after 10:30, we could not. And then that patient who is positive, he’s crying, he’s shocked with his result. And an aftershock: He cannot get medicine immediately. And then he asked, Why, why, why, why? And then the counselor, he didn’t know how to tell that client. And then he feels very sad. He feels very, very guilty with himself.

Even before the U.S. funding pause was announced, SWING was already drawing the majority of its support from Thailand’s National Health Security Office.

No one can give us money forever. Even our parents, they are supporting us when we graduate, after that we have to support ourselves. This is the same. We prepare about the transition.

That’s why we start to do our clinic, we try to show the results to the government, that community people can provide a healthcare service by ourselves. We have to be in the health system of the country and then we should get the funding from the government.

But PEPFAR still made up about 30 percent of SWING’s budget and essentially underwrote entire services, including the organization’s prevention and outreach efforts.

Chanyam got the news about the funding suspension in the car driving back to Bangkok and immediately began strategizing about how to maintain all of SWING’s programs without PEPFAR support. Despite Washington framing it as a pause to review foreign aid, she immediately assumed the money was gone for good – particularly since SWING works with communities that are anathema to the Trump administration.

I totally, 100 percent, will not lay off staff. We said, Okay, we have to work very hard to get more funding from the National Health Security Office. To do the mobile clinic, to do everything to get more funding from the domestic funding. This can help us survive.

But the National Health Security can support only just the Thai people. Not cover for migrants. That’s the challenge for us.

Migrants make up about 10 percent of their clients. SWING is looking for other sources of support, even as Chanyam draws on the organization’s savings to maintain the migrant services.

It helps that the situation is not quite as dire as she first feared. Some PEPFAR funding has been restored to support life-saving services, like treatment. But it is renewed on a month-by-month basis and now comes with conditions like not mentioning SWING’s relationship with the program. So she is not relying on it.

Every funder, they can stop. But the stop funding should have time for us to prepare. We are not working with a machine. We are working with humans. We are working on life saving. We cannot stop like a machine. This makes a big problem for the people who are in need of support to survive.